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Home , Not About Heroes, Wilfred Owen

‘Re-education’, ergotherapy and the doctor who cured

The end of 2020 marks the 100th anniversary of Wilfred Owen’s war being published posthumously.1 A quarter of Owen’s poems and fragments were written or updated in late 1917 when he was a ‘shell-shock’ patient in ’s War Hospital. Here he penned his most remembered verse. Without Craiglockhart and the care of Edinburgh doctor, Dr Arthur John Brock, we may never have read Owen’s words on ‘the pity of war’.2 A century on, Brock’s ‘ergotherapy’ treatments may have resonance and applicability as we care for mental health issues emanating from current global crises.

In 1917 Owen saw action in the Somme area of the Western Front. He became a casualty having fallen into a shell hole. Recovering from concussion he was later blown up by a trench mortar and reportedly spent days unconscious. On regaining consciousness, Owen found himself surrounded by the remains of a fellow officer. Owen was transferred to one of the two reception centres for ‘shell-shock’, the Royal Victoria Hospital (the Welsh Hospital, Netley), where he was diagnosed as suffering from ‘war neuroses’ by doctors there. He was then moved to one of Britain’s six ‘shell-shock’ hospitals for officers - Craiglockhart War Hospital in Edinburgh. There he was placed under the care of Dr Brock.

Brock believed in purging what caused the shock before a programme of ‘re-education’3 whereby patients were returned to normal living and working. This involved ‘ergotherapy’ activities. ‘Ergotherapy’ is the use of physical exertion as a treatment4 or as Brock described it more widely, “cure by functioning.”5 His prescribed activities were both physical and active artistic engagement, stimulating the body and mind. Getting patients to function again was in real life, active and engaging contexts. Various ‘re-education’ activities took place: outdoor field trips; model making; work experience leading Scout troops, Boys’ Clubs or school classes; organising and taking part in arts productions. This was different from other wartime ‘shell-shock’ treatments including disciplinary physical approaches, electric

1 Owen, Wilfred (1920) Poems by Wilfred Owen, Chatto & Windus, . 2 McLennan, NDR 2018, '"Six o'clock Princes Street": An Analysis of Wilfred Owen's Edinburgh Re- Education', Proceedings of the Society of Antiquaries of . 3 Brock, AJ. (1918) ‘The Re-Education of the Adult: The Neurasthenic in War and Peace.’ The Sociological Review, Vol 10, 1918, pp 25-40, p. 31. 4 N., Pam M.S., “Ergotherapy” in Psychology Dictionary, April 7, 2013 https://psychologydictionary.org/ergotherapy/ (accessed 19 October, 2020). 5 Brock (1918), p. 31. treatments and water, psychotherapeutic, psychoanalysis and psychodynamic therapies. Brock felt productive activity served the participant and beneficiaries. Brock stated; “Each man must work individually – like an artist- and further, he must strive to relate his work to those of his fellows.”6 Brock paired patients for support and socialisation.

Owen’s first activity for Brock was to write an essay following an expedition. This stimulated Owen’s writing and soon it was poems he was producing. Amongst them were some of his most powerful works ‘’ and ‘.’ The content for them came from Owen’s Western Front experience, but the catalyst for writing them was Brock’s innovative medico-education ergotherapy treatment. Owen’s poetic outpouring was part of his recovery.

Until recently Brock’s contribution was not fully recognised. There are only two accounts solely dedicated to Owen’s Edinburgh recovery.7 Both are fictional. Both feature Brock, although not as the central character. The role of Brock was the subject of a 2003 RCPE Journal paper8 as was Cantor’s account of Brock’s medical humanism.9 The former called for a “fuller investigation … [of] this fascinating episode in Edinburgh’s medical history.”10 Since then, new research and a public education programme add to our knowledge of Wilfred Owen’s convalescence in Edinburgh.11 We can now recognise Brock and his important impact on Owen’s treatment and writing.

Owen suffered during war and also witnessed Spanish Flu’s later devastation. He noted 1/3 of his battalion ‘smitten’ with it [flu], makeshift hospitals in gymnasium halls filled with

6 Brock (1918). P. 33. 7 MacDonald, Stephen (1987) (Samuel French Inc.); Barker, Pat (1991) (Viking Press, London). 8Crossman, AM, (2003) The Hydra, Captain AJ Brock and the treatment of shell-shock in Edinburgh, Royal College of Physicians of Edinburgh Journal, Vol 33, Issue 2, pp. 119-123. 9 Cantor, David (2005), Between Gallen, Geddes and the Gael: Arthur Brock, and Medical Humanism in Early Twentieth Century Scotland, in Journal of the History of Medicine and Allied Services, Volume 60, Number 1, January 2005, pp. 1-41. 10 Crossman (2003), p. 122.

11 Wilfred Owen’s Edinburgh 1917:2017 http://www.napier.ac.uk/Wilfred-Owen-100; McLennan, 2018; McLennan, NDR 2018b, 'Gravesiana: When Graves, Owen and Sassoon met', Gravesiana: The Journal of the Society, vol. 4, no. 3, pp. 490-502; McLennan, NDR 2016a, 'Edinburgh's Pentland Hills: Wilfred Owen's 'Oxford University'', Wilfred Owen Association Journal, vol. 2016-1, no. 1, pp. 14-17. cases and only the worst affected getting beds.12 Writing to his mother, he instructed her to:- “STAND BACK FROM THE PAGE! and disinfect yourself”13

A century after ‘the Great War’ ended and the Spanish Flu struck, we might consider that Brock’s treatment was supporting those dislocated from their surrounding environs and supports. Activity, the outdoors and social interaction all supported Owen being certified fit by a Medical Board. On leaving Craiglockhart Owen noted; “I am beginning to have aching sensations at being rooted up from this pleasant Region.”14 “Rooted up” is an interesting phrase, comparing humans with plants and recognising the environment which nourishes them.

Brock’s success was the ultimate irony - recovery meant Owen returning to war. Owen was shot and killed in , a week before the war ended. This jars with the Hippocratic Oath that Brock himself wrote about.15 Such ‘wicked issues’ emerge again and again in medical ethical dilemmas.

Ergotherapy may be a useful approach in reconnecting humankind with their environs, society and self. Ergotherapy helped Owen recover from ‘shell-shock’ and write some of the most powerful poetic lines of the twentieth century. Owen’s poem ‘Conscious’ has a keen eye for the environment around a patient and the medical staff who re-assure and support:-

His fingers wake, and flutter; up the bed His eyes come open with a pull of will, Helped by the yellow mayflowers by his head. The blind-cord drawls across the window-sill… What a smooth floor the ward has! What a rug! Who is talking somewhere out of sight? Three flies are creeping round the shiny jug… ‘Nurse! Doctor!’- ‘Yes, all right, all right.’16

12 Wilfred Owen to Susan Owen 24 June 1918 in Bell , John (1985) Wilfred Owen: Selected Letters (OUP, Oxford), p. 335 13 Ibid. 14 Wilfred Owen to Susan Owen, 29 October 1917 in Bell (1985), p. 287. 15 Brock, Arthur John (translated, 1916) Galen on the Natural Faculties, Heinemann, London. 16 Owen (1920), p. 27. Brock’s legacy will be inspiring Owen, while his fuller contribution was humanising healthcare during an inhumane period of our history.